Healthcare Provider Details

I. General information

NPI: 1568886489
Provider Name (Legal Business Name): NADDI MARAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18980 W. MEMORIAL DR SUITE 100
HUMBLE TX
77338
US

IV. Provider business mailing address

18980 W MEMORIAL DR SUITE 100
HUMBLE TX
77338
US

V. Phone/Fax

Practice location:
  • Phone: 832-644-8930
  • Fax: 855-227-3560
Mailing address:
  • Phone: 832-644-8930
  • Fax: 855-227-3506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberS0735
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberS0735
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: